微探头超声内镜联合腹部彩超在结肠癌患者临床分期中的应用  

Clinical application of preoperative TNM staging with ultrasound mini-probe combined with ultrasonography in diagnosis of colorectal cancer

作　　者：王东旭[1] 周舒頔 朱宏斌[1] 苏玲[2] 

机构地区：[1]中国人民解放军第二五四医院消化内科,天津300142 [2]中国人民解放军第二五四医院特诊科,天津300142

出　　处：《重庆医学》2016年第23期3215-3217,共3页Chongqing medicine

基　　金：天津市卫计委科技基金(2015KZ004;2015KZ005)

摘　　要：目的评价微探头超声内镜与腹部超声联合应用对提高大肠癌患者的临床分期准确性及特异性的价值。方法应用微探头超声内镜及其与B超联合的检查方法分别对88例大肠癌患者进行术前TNM分期,并与术后病理结果进行比较。结果微探头超声内镜术前大肠癌浸润深度的分期和是否有淋巴结转移与术后病理结果分期的总符合率分别为78.4%和72.7%,T1、T2、T3和T4的符合率分别为88.9%、73.9%、80.6%和76.0%;无淋巴结转移(N-)和有淋巴结转移(N+)的符合率分别为75.0%和71.9%。微探头超声内镜与B超联合对淋巴转移的准确度、敏感度及特异性均高于单独应用微探头超声内镜检查,但差异无统计学意义。结论微探头超声内镜是大肠癌浸润深度分期的有效手段之一,结合其他影像学检查有助于提高TNM分期准确性。Objective To evaluate the value of ultrasound mini-probe （UMP） combined witk B-scan in preoperative TNM staging for the diagnosis of colorectal cancer. Methods UMP and its combination with ultrasonography were used to perform pre- operative TNM staging for 88 cases of colorectal cancer, respectively. The findings were compared with postoperative pathological outcomes. Results The percentages of concordant diagnosis of intensity of colorectal cancer or lymph node metastasis by UMP and postoperatively pathological findings were 78.4% and 72.7% respectively. The percentages of concordant diagnosis of T1, T2, T3 and T4 was 88.9 0%, 73.9 %, 80.6% and 76.0 %. In terms of lymph node metastasis, the rate was 75.0% in the N negative group and 71.9 % in the N positive group. Although there were higher total accuracy, sensitivity and specificity in diagnosis of lymph node me- tastasis （N） by UMP combined with B-scan than that of UMP test in all cases,there was no statistically different（P〉0.05）. Con- clusion UMP is one of the effective practical procedures in preoperative TNM staging of colorectal cancer. In diagnosis of preoper- ative TNM staging of colorectal cancer, UMP should be combined with other imaging techniques such as ultrasonography in order to improve the accuracy and integrity of preoperative staging in colorectal cancer.

关 键 词：结肠恶性肿瘤 TNM分期 微探头超声内镜 

分 类 号：R445.1[医药卫生—影像医学与核医学]